Background: Psychiatric diseases such as bipolar disorder, major depressive disorder (MDD)and schizophrenia are chronic ailments that severely affect daily function and quality of life. A relationship between elevated levels of proinflammatory cytokines and these disorders hasbeen suggested in several studies. Lithium is used as a treatment in bipolar disorder, and as anadjunctive treatment in MDD and schizophrenia. Despite the extensive use of lithium, it’smechanism of action is not fully understood. One of the proposed hypotheses of lithium’smechanism of action is reduction in the levels of proinflammatory cytokines. Aim: The aim of this systematic literature review is to describe the effects of lithium onproinflammatory cytokines (IL-1, IL-6, INF- γ, TNF) in bipolar disorder, MDD andschizophrenia. Methods: The study was conducted through a search in the electronic database PubMed.Using the PICOS format, inclusion and exclusion criteria were specified. Search words andfilters were combined using both Medical Subject Headings (MeSH) terms and free textsearch words. The search initially resulted in 105 articles and through inclusion and exclusioncriteria full-text articles were estimated for eligibility. Risk of bias was estimated using theCochrane Handbook. Results: A total of 10 eligible articlets were included in this study. Nine out of 10 articlesinvestigated bipolar patients, and one article investigated patients with MDD. No article investigated patients with schizophrenia. Four out of 9 articles regarding bipolar patientsreported a significant decrease in some proinflammatory cytokines after lithiumtreatment, 4 articles reported a significant increase, and one article reported no change in theproinflammatory cytokines. In two well conducted studies where bipolar disorder wasinvestigated, lithium had differential effects, namely decreasing proinflammatory cytokines inlithium responders compared to lithium non-responders. No significant change inproinflammatory cytokine levels after lithium treatment were found in the article studyingMDD patients. Conclusions: The results indicated that lithium may have different effects depending onwhich specific cytokine was studied and on the specific characteristics of the studiedpopulation. Therefore, the outcomes of our review cannot unequivocally answer whetherlithium acts by increasing or decreasing proinflammatory cytokines, or both depending on theexperimental conditions. Further research is needed to fully elucidate the relationship betweenlithium and proinflammatory cytokines in bipolar disorder, MDD and schizophrenia.
| Identifer | oai:union.ndltd.org:UPSALLA1/oai:DiVA.org:oru-73977 |
| Date | January 2019 |
| Creators | Helgesen, Johanna |
| Publisher | Örebro universitet, Institutionen för medicinska vetenskaper |
| Source Sets | DiVA Archive at Upsalla University |
| Language | English |
| Detected Language | English |
| Type | Student thesis, info:eu-repo/semantics/bachelorThesis, text |
| Format | application/pdf |
| Rights | info:eu-repo/semantics/openAccess |
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